Paediatria Croatica, Vol. 54 No. 4, 2010.
Professional paper
PLEUROPULMONARY FISTULA DUE TO GRASS BLADE ASPIRATION IN A CHILD
Ivo Glunčić
; Klinički bolnički centar Split, Klinika za ORL, Spinčićeva 1, Split
Draško Cikojević
Marisa Klančnik
Irena Babić
Abstract
We report on a 11-year-old boy with pleuropulmonary fistula caused by grass blade aspiration into the right bronchus. An 11-year-old boy was admitted for suspected grass blade aspiration on the previous day. The child presented with continuous cough, auscultation revealed enhanced breathing basally on the right, and lung X-ray showed a normal finding. Rigid bronchoscopy was indicated. During anesthesia induction, the child developed an allergic reaction to thiopental (Nesdonal) and the bronchoscopy was discontinued. Bronchoscopy with another anesthetic (sevoflurane) was repeated on the following day; however, rigid bronchoscopy failed to remove the grass blade that had moved more distally. Then intensive antibiotic and other symptomatic therapy was introduced. The patient developed empyema with signs of partial pneumothorax. On day 15 of hospital stay, right-sided thoracotomy was performed and revealed a pleuropulmonary fistula with gangrene involving half of the inferior lung lobe. The grass blade was found in the right interpleural space. Upon removal of the grass blade and gangrenous lung segments, the child recovered well, with only mild respiratory insufficiency. After suspicion of foreign body aspiration bronchoscopy must be performed immediately.
Keywords
FOREIGN BODIES; BRONCHOSCOPY; FISTULA; PNEUMONIA, ASPIRATION; CHILD
Hrčak ID:
64941
URI
Publication date:
22.12.2010.
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